United Medical Center must address ‘structural challenges,’ consultants say

The District-owned United Medical Center needs to affiliate with a broader network of hospitals, doctors and clinics in order to have any hope of gaining financial viability, a team of consultants reported to city officials Tuesday.

Huron Healthcare, hired by the District on a $12.7 million contract, said in a presentation to Mayor Vincent C. Gray (D) and D.C. Council members that the city’s only full-service hospital located east of the Anacostia River suffers from “structural challenges” that could complicate any partnership.

Those include inadequate medical staffing, “alarmingly low” patient satisfaction rates and the fact that the vast majority of patients in the hospital’s vicinity choose to receive care elsewhere.

“Operating improvements alone will not eliminate UMC’s annual cash deficit,” the consultants said in their presentation at the hospital.

Huron’s findings are the latest in a series of independent assessment of the facility on Southern Avenue SE formerly known as Greater Southeast Community Hospital. The hospital has deep support among elected officials who consider it crucial to maintain an east-of-the-river hospital, but it has chronically struggled to maintain financial stability during the past 15 years.


United Medical Center (formerly the Greater Southeast Community Hospital) in Washington. (Sarah L. Voisin/THE WASHINGTON POST)

The consultants presented a menu of six scenarios for the hospital, ranging from its closure — carrying “significant political, operational and employment implications” — to various restructuring models. One option promoted by a previous set of consultants — remaking the hospital into an outpatient-only “ambulatory” care center — was largely dismissed by Huron as “unlikely to be profitable.”

That conclusion pleased D.C. Council member Yvette M. Alexander (D-Ward 7), who has opposed the suggestion that the hospital needs to reduce or eliminate its inpatient beds: “I’m happy to see that they recognized that no hospital is not an option and that solely ambulatory care is not an option,” she said. Alexander, chairman of the council’s Health Committee, said she favors a “focused community hospital” option with where inpatient beds are maintained and the hospital’s and a beefed-up medical staff.

Huron reported that upward of 85 percent of D.C. hospital patients living east of the Anacostia choose facilities other than United Medical Center. Alexander said that is in part because of a lack of medical specialists at the hospital.

Under its contract, Huron assumed management of United Medical Center in late March. It is undertaking a “strategic review” of the hospital’s operations and is expected to develop a proposal to help turn around the hospital in the coming weeks for the approval of the hospital’s board in July.

The city in March injected $11 million into the hospital’s accounts to easecure a cash shortfall that had strained relationships with vendors. Although the cash crunch has eased, the underlying financial dysfunctions have not. In the six months ending in March, the hospital ran a $3.7­ million operating loss — a significant reversal from the year before, when the hospital ran a $4.7 million surplus, thanks in large part to a stream of federal funding for safety-net hospitals that has since evaporated. Continuing under the current model, the consultants said, would require ongoing annual commitments of $12 million to $15 million in taxpayer funds — something that is “not a realistic option,” Huron concluded.

It remains unclear what further city government resources would be needed to transform the hospital so that it would appeal to a private health network. The hospital’s dismal situation, the Huron presentation said, makes United Medical Center “a challenging option for a partner or sale.”

“Challenging, but not an impossibility,” said Pedro Ribeiro, a spokesman for Gray.

Mike DeBonis covers local politics and government for The Washington Post. He also writes a blog and a political analysis column that runs on Fridays.
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